Goldenbaum Donald M, Christopher Myra, Gallagher Rollin M, Fishman Scott, Payne Richard, Joranson David, Edmondson Drew, McKee Judith, Thexton Arthur
Research, Evaluation, and Publications Program, Center for Practical Bioethics, Kansas City, Missouri 64105-2116, USA.
Pain Med. 2008 Sep;9(6):737-47. doi: 10.1111/j.1526-4637.2008.00482.x. Epub 2008 Jul 24.
To provide a "big picture" overview of the characteristics and outcomes of recent criminal and administrative cases in which physicians have been criminally prosecuted or charged by medical boards with offenses related to inappropriate prescribing of opioid analgesics.
We identified as many criminal and administrative cases of these types as possible that occurred between 1998 and 2006. Cases were identified using a wide variety of sources, including organizational and government agency databases, published news accounts, and Web sites. Factual characteristics of these cases and their outcomes, and of the physicians involved, were then further researched using additional sources and methods.
Study findings are intended to apply to practicing U.S. patient care physicians as a whole.
There were no patients or participants in this study. Outcome Measures. We analyzed the numbers and types of cases and physicians involved, criminal and administrative charges brought, case outcomes and sanctions, specialties, and other characteristics of the physicians involved.
The study identified 725 doctors, representing an estimated 0.1% of practicing patient care physicians, who were charged between 1998 and 2006 with criminal and/or administrative offenses related to prescribing opioid analgesics. A plurality of these (39.3%) were General Practice/Family Medicine physicians, compared with 3.5% who were self-identified or board-certified pain specialists. Physicians in this sample were more likely to be male, older, and not board certified (P < 0.001). Drug Enforcement Administration (DEA) criminal and complaint investigations averaged 658 per year (2003-2006) and "for cause" surrenders of DEA registrations averaged 369.7 (2000-2006).
Criminal or administrative charges and sanctions for prescribing opioid analgesics are rare. In addition, there appears to be little objective basis for concern that pain specialists have been "singled out" for prosecution or administrative sanctioning for such offenses.
全面概述近期刑事和行政案件的特征及结果，这些案件涉及医生因不适当开具阿片类镇痛药而受到刑事起诉或被医疗委员会指控。
我们尽可能多地找出1998年至2006年间发生的此类刑事和行政案件。通过多种来源确定案件，包括组织和政府机构数据库、已发表的新闻报道及网站。然后利用其他来源和方法进一步研究这些案件的实际特征、结果以及涉案医生的情况。
研究结果旨在适用于美国全体执业的患者护理医生。
本研究无患者或参与者。结局指标。我们分析了涉案案件和医生的数量及类型、提出的刑事和行政指控、案件结果及处罚、专业以及涉案医生的其他特征。
该研究确定了725名医生，约占执业患者护理医生的0.1%，他们在1998年至2006年间被指控犯有与开具阿片类镇痛药相关的刑事和/或行政罪行。其中多数（39.3%）是全科/家庭医学医生，相比之下，自称或获得委员会认证的疼痛专科医生占3.5%。该样本中的医生更可能为男性、年龄较大且未获得委员会认证（P<0.001）。美国药品执法管理局（DEA）的刑事和投诉调查在2003 - 2006年平均每年658起，DEA注册“因故”交出平均为369.7起（2000 - 2006年）。
因开具阿片类镇痛药而受到刑事或行政指控及处罚的情况很少见。此外，几乎没有客观依据担心疼痛专科医生因这类罪行而被“单独挑出”进行起诉或行政制裁。
